https://doi.org/10.37527/2021.71.S1
1Emory University, Atlanta, United States, 2Nutrition International, Ottawa, Canada, 3Food Fortification Initiative & Emory University, Atlanta, United States.
Background. Food fortification has the potential to deliver essential micronutrients to populations at large scale, thereby reducing nutritional anemia.
Objective. The purpose of this project was to review literature and conduct a meta-analysis to identify the proportion of anemia ameliorated by fortification of wheat flour, maize flour, rice and oil (singly or combined) among adolescent girls and women of child-bearing age from across the globe.
Methods. A search in 17 online databases between November 14, 2020, and December 4, 2020 yielded 2284 results. Only English-language documents were included and no restrictions on location or publication date were imposed. Relevant references from systematic reviews and meta-analyses were checked for inclusion. Longitudinal, pre-post cross-sectional, efficacy and effectiveness studies were included. Primary outcomes were change in hemoglobin concentration and change in anemia prevalence. Two reviewers independently screened document abstracts and titles (via Covidence) and extracted key information from all studies (via Excel). Studies will be synthesized using arm-based network meta-analysis with the pcnetmeta package in R.
Results. We will calculate individual and pooled estimates of the effect sizes of fortified maize flour, wheat flour, rice, and oil on nutritional anemia reduction among women of reproductive age. Results will be stratified by food vehicle, nutrients added, intervention duration, severity of anemia during the pre-fortification assessment, public health significance of anemia during the pre-fortification assessment, and women’s age (10-19, 15-49, 10-50 years).
Conclusions. We expect further evidence of the impact of grains and oil fortification on anemia. Compared to previous systematic reviews which focused on food fortification and nutritional anemia in low- and middle-income countries among select population groups, this analysis will solely assess the impact of maize flour, wheat flour, rice, and oil fortification on nutritional anemia across multiple countries irrespective of income levels among adolescent girls (10-19 years) and women of child-bearing age (15-49 years).
Keywords: enrichment, women, maize flour, oil, rice, wheat flour.